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Added by: Clotilde Torregrossa, Contributed by: Simon Fokt
Abstract: To be autonomous is to be a law to oneself; autonomous agents are self-governing agents. Most of us want to be autonomous because we want to be accountable for what we do, and because it seems that if we are not the ones calling the shots, then we cannot be accountable. More importantly, perhaps, the value of autonomy is tied to the value of self-integration. We don't want to be alien to, or at war with, ourselves; and it seems that when our intentions are not under our own control, we suffer from self-alienation. What conditions must be satisfied in order to ensure that we govern ourselves when we act? Philosophers have offered a wide range of competing answers to this question.Heal, Jane. Mental disorder and the value(s) of ‘autonomy’2012, In Autonomy and Mental Disorder, Lubomira Radoilska (ed.). New York: Oxford University Press, 3-25.-
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Added by: Jamie RobertsonAbstract:
Summary (from Introduction of Autonomy and Mental Disorder, Radoilska ed.): In 'Mental disorder and the value(s) of autonomy', Jane Heal identifies and critically examines a form of thought which is implicit in discussions about what we, as a society, owe to people with mental disorder. This form of thought builds upon intuitions which link respect for a person with respect for a person's autonomy. In light of these intuitions, the issue of how to treat a person with mental disorder may seem to revolve around the question whether or not this person has the capacity for autonomy. However, Heal argues, inquiries that share this logical form are methodologically inappropriate and potentially unhelpful in answering either of the questions they put together: what we owe to people with mental disorder and what is involved in autonomy as a capacity. The reason for this is twofold. Firstly, the apparent consensus about autonomy as a capacity for self-determination that ought to be protected from interference by a corresponding right to self-determination is too shallow to ground a coherent course of action in terms of respect for autonomy. Even if we work with the assumption that autonomy is part of the Enlightenment project, we face an important dilemma since we have to choose between a Kantian or rationality oriented and a Millian or well-being oriented take on the nature and significance of autonomy. Secondly, even if we were to reach a substantive consensus on the concept of autonomy, it would arguably require an intricate array of mental capacities, outside the reach of at least some people with mental disorder. Getting clearer on what autonomy is will not help us find out what it means to treat these people respectfully.Comment: This text would be a good candidate for inclusion in a course about autonomy, philosophy of disability, or the ethics or political philosophy of mental health or aging (due to discussion of dementia). If assigned as part of a course on autonomy, students will benefit from considering Heal's approach to breaking down the logical components of the concept and her nuanced discussion of the limitations of autonomy as a moral principle for understanding our obligations toward people with mental disorders. This second element is the central question of the paper and would be of interest when examining disability or mental health from a philosophical perspective.
O'Neill, Onora. Autonomy and Trust in Bioethics2002, Cambridge University Press.-
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Added by: Chris Howard, Contributed by: Simon Fokt
Publisher's Note: Onora O'Neill suggests that the conceptions of individual autonomy (so widely relied on in bioethics) are philosophically and ethically inadequate; they undermine rather than support relationships based on trust. Her arguments are illustrated by issues raised by such practices as the use of genetic information by the police, research using human tissues, new reproductive technologies, and media practices for reporting on science, medicine, and technology. The study appeals to a wide range of readers in ethics, bioethics, and related disciplines.Comment: Parts of this book are an excellent supplement to units on autonomy and informed consent in an intermediate-advanced level medical ethics course. In particular, chapters 1, 2, and 4 would be excellent additions to a unit on autonomy, and chapter 7 would be a similarly excellent addition to a unit on informed consent.
Todd, Loretta. Notes on Appropriation1990, Parallelogramme 16(1): 24-33.-
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Added by: Erich Hatala Matthes
Summary: Todd (Métis) situates contemporary acts of cultural appropriation in the colonial appropriation of indigenous land. She offers a normative definition of cultural appropriation according to which it is understood as the opposite of cultural autonomy. In the course of her discussion, she responds to a number of defenses of cultural appropriation that, she argues, fail to recognize the asymmetries of power in which appropriation from indigenous communities is embedded.Comment: This is an excellent text to use in order to present students with a conception of the wrong of cultural appropriation that is firmly rooted in the context of colonial power dynamics. It is short, and can be usefully compared and contrasted with the arguments presented by James O. Young in "Profound Offense and Cultural Appropriation.".
Terlazzo, Rosa. Conceptualizing Adaptive Preferences Respectfully: An Indirectly Substantive Account2016, The Journal of Political Philosophy 24(2): 206-226.-
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Added by: Carl Fox
Abstract: While the concept of adaptive preferences is an important tool for criticizing injustice, it is often claimed that using the concept involves showing disrespect for persons judged to have adaptive preferences. In this paper, I propose an account of adaptive preferences that does the relevant political work while still showing persons two centrally important kinds of respect. My account is based in what I call an indirect substantive account of autonomy, which places substantive requirements on the options available to a person, rather than on the option that she ultimately prefers. This allows us to pinpoint cases in which a person's circumstances have rendered her insufficiently autonomous, without saying that any conception of the good must be non-autonomous tout court.Comment: This article would make good recommended reading for a session taking an in-depth look at adaptive preferences, or further reading if the topic was autonomy and the session broached questions about preference formation.
Begon, Jessica. Paternalism2016, Analysis 76(3): 355-373.-
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Added by: Carl Fox
Summary: Analysis review article of recent work on the topic of paternalism. Discusses different ways in which the term is defined, reviews the debate between 'paternalists' and 'anti-paternalists', and presents soft paternalism.Comment: Could be used as an introductory reading to the topic of paternalism, or a further reading to provide a comprehensive background to recent work in the area.
Hurd, Heidi. The Moral Magic of Consent1996, Legal Theory 2(2): 121-146.-
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Added by: Carl Fox
Abstract: We regularly wield powers that, upon close scrutiny, appear remarkably magical. By sheer exercise of will, we bring into existence things that have never existed before. With but a nod, we effect the disappearance of things that have long served as barriers to the actions of others. And, by mere resolve, we generate things that pose significant obstacles to others' exercise of liberty. What is the nature of these things that we create and destroy by our mere decision to do so? The answer: the rights and obligations of others. And by what seemingly magical means do we alter these rights and obligations? By making promises and issuing or revoking consent When we make promises, we generate obligations for ourselves, and when we give consent, we create rights for others. Since the rights and obligations that are affected by means of promising and consenting largely define the boundaries of permissible action, our exercise of these seemingly magical powers can significantly affect the lives and liberties of othersComment: Good introduction to the topic of consent as it makes clear both how strange it is as a power and how pervasive it is in our moral practices. Goes on to provide an interesting argument for consent as a subjective mental state and offers an account of what that might be. Could support a lecture or seminar on consent, or would make good further reading if the topic is only touched on briefly.
Corrigan, Oonagh. Empty Ethics: The Problem with Informed Consent2003, Sociology of Health & Illness, 25 (3): 768-792.-
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Added by: Rochelle DuFord
Abstract: Informed consent is increasingly heralded as an ethical panacea, a tool to counter autocratic and paternalistic medical practices. Debate about the implementation of informed consent is constricted and polarised, centring on the right of individuals to be fully informed and to freely choose versus an autocratic, paternalistic practice that negates individual choice. A bioethical framework, based on a principle-led form of reductive/deductive reasoning, dominates the current model of informed consent. Such a model tends to abstract the process of consent from its clinical and social setting. By fleshing out the social process involved when patients and healthy volunteer subjects consent to take part in clinical drug trials, this paper attempts to address the problem arising from the current 'empty ethics' model. My arguments are substantiated by qualitative interview data drawn from a study I conducted on the process of consent as experienced by participants in clinical drug trials.Comment: This text is a clear critique of the use of informed consent as a medical-ethical panacea (it could be taught alongside O'neill's "Paternalism and Partial Autonomy" for a more accessible and applied look at the problem of informed consent). It would be useful as a contrast at the end of a unit on informed consent for medical treatment or a unit on clinical research ethics. It is especially good for use in a biomedical ethics or research ethics course aimed at students interested in the health professions.
Kittay, Eva Feder. Forever Small: The Strange Case of Ashley X2011, Hypatia, 26 (3): 610-631.-
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Added by: Rochelle DuFord
Abstract: I explore the ethics of altering the body of a child with severe cognitive disabilities in such a way that keeps the child 'forever small.' The parents of Ashley, a girl of six with severe cognitive and developmental disabilities, in collaboration with her physicians and the Hospital Ethics Committee, chose to administer growth hormones that would inhibit her growth. They also decided to remove her uterus and breast buds, assuring that she would not go through the discomfort of menstruation and would not grow breasts. In this way she would stay 'forever small' and be able to be carried and handled by family members. They claimed that doing this would ensure that she would be able to be part of the family and of family activities and to have familial care. But the procedure has raised thorny ethical questions. I wish to explore these questions philosophically by bringing to bear my own experiences as a mother of a grown daughter with severe cognitive impairments.Comment: This reading both introduces the controversial case of Ashley X and also provides a set of ethical considerations concerning altering the bodies of persons with severe cognitive disabilities. It would serve as an excellent introduction to a unit on disability, a unit on the ethics of care, or concerning the limits of parental paternalism.
Conly, Sarah. One Child: Do We Have a Right to More?2016, Oxford: Oxford University Press.-
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Added by: Rochelle DuFord
Summary: A compelling argument for the morality of limitations on procreation in lessening the harmful environmental effects of unchecked population. We live in a world where a burgeoning global population has started to have a major and destructive environmental impact. The results, including climate change and the struggle for limited resources, appear to be inevitable aspects of a difficult future. Mandatory population control might be a possible last resort to combat this problem, but is also a potentially immoral and undesirable violation of human rights. Since so many view procreation as an essential component of the right to personal happiness and autonomy, the dominant view remains that the government does not have the right to impose these restrictions on its own citizens, for the sake of future people who have yet to exist. Sarah Conly is first to make the contentious argument that not only is it wrong to have more than one child in the face of such concerns, we do not even retain the right to do so. In One Child, Conly argues that autonomy and personal rights are not unlimited, especially if one's body may cause harm to anyone, and that the government has a moral obligation to protect both current and future citizens. Conly gives readers a thought-provoking and accessible exposure to the problem of population growth and develops a credible view of what our moral obligations really are, to generations present and future.Comment: This book would be an excellent resource for an upper-division course on population ethics, ethcs of reproduction, autonomy, or human rights. It would also serves as a good overview of positions in population ethics or as a supplement to a class on environmental ethics and future generations.
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Buss, Sarah. Personal autonomy
2008, Stanford Encyclopedia of Philosophy.
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